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NPI Code Detail

MEDICARE: RISING SPURS ABA THERAPY CORP

MEDICARE: RISING SPURS ABA THERAPY CORP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106E00000XAssistant Behavior Analyst
2106S00000XBehavior Technician
3103K00000XBehavior Analyst

General Provider Information

NPI Number : 1285470195
Entity Type Code : Organization
Provider Name (Legal Business Name) : RISING SPURS ABA THERAPY CORP
Provider Business Mailing Address
First Line : 1209 N SAGINAW BLVD, SUITE G
Second Line : PMB 116
City : SAGINAW
State : TX
Zip : 76179
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8400 BUCK MOUNTAIN PASS
Second Line :
City : FORT WORTH
State : TX
Zip : 76179-3098
Country : US
Telephone Number : 305-778-5357
Fax Number :
Authorized Official
Title or Position : OWNER/CEO
Name : VALENTINA SASTOQUE SOTELO
Credential :
Telephone Number : 305-778-5357
Provider Enumeration Date : 07/01/2024
Last Update Date : 07/10/2024

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Directions to “RISING SPURS ABA THERAPY CORP ” Practice Location

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